St. Petersburg State University
Faculty of Medicine
Abstract for the course "History of Medicine" on the topic:
"The history of the development of nursing in Russia"
1st year student 101 gr. E. Yu. Katselnik
Introduction
Main part
The beginning of formation. Reforms of Peter I
Nursing 2 half of the XVIII century. The reign of Maria Feodorovna
The first guide to nursing. Christopher von Oppel
The emergence of sisters of mercy communities in Russia
Nursing during the Crimean War (1853-1856)
The formation of the training process for nurses
Nursing in Russia after the revolution, as well as during the Great Patriotic War
The current stage of development of nursing
Conclusion
Application
Bibliography
2. Introduction
Nursing is an integral part of medicine. Nowadays, no doctor can do without the help of a nurse. Moreover, nurses in various directions Medicine often takes a very different approach to patients. In order to become a qualified nurse, it is now not enough just the desire and opportunity to study and work.
Modern nursing is a whole complex of sciences, only after studying which one can rightfully be called a “nurse”. In addition, nursing is based on a good philosophical basis, which describes the spiritual qualities necessary for a future nurse to successfully perform their duties and establishes the basic principles of work.
In this work I would like to focus on the development of nursing in Russia. This topic is interesting to me, firstly, because of the history of Russia, rich in various events that had a direct impact on the formation of nursing. Secondly, I was interested to know how this process took place here, in Russia, in the country where I was born and live, and where I am also going to become a doctor.
In the main part of my work, I tried to present the process of development of nursing in stages, supplementing the basic data interesting facts and specific cases.
In the appendix you can see photographs illustrating appearance and the work of sisters of mercy at different times.
3. Main part
The beginning of formation. Reforms of Peter I.
Nursing - not as a social phenomenon in monastic hospitals, but as an officially approved and regulated profession in hospitals and social institutions - owes its birth in Rus' to the reign and reforms of Peter I (1672-1725). The creation of the Russian regular army and navy laid the foundation for the development of a regular military medical organization. Military medicine, in turn, could develop progressively only under the condition of the same progressive rise in civilian medicine.
The beginning of nursing in Russia was marked by the following events.
In 1715, by decree of Peter I, educational homes were created in which women were supposed to serve. (1)
Responsibilities included caring for healthy and sick children. Often these were newborn foundlings. Orphanages of this type were in the center of public attention and received numerous donations from private individuals.(2)
In 1716, the “Military Charter” legally regulated the organization of medical care for the wounded and the participation of women in caring for them. According to the Charter: “Ordinary soldiers in the field and campaigns often fall ill from great labor and work and are wounded during cruel actions, for this reason there is a need to build a field hospital.” Such an infirmary “could be established in some place, in a village or city, or in some wards, as the case may require.” The infirmary is headed by “a special hospital inspector, a doctor, a priest, a physician, with a good (i.e., good, benign) field pharmacy and with some apprentices.”
“It is always necessary to be with ten sick people to serve one healthy soldier and several women who have to serve these sick people and wash their clothes...”
As can be seen from the Decree, women's care in hospitals began with the organization of a service to provide patients with clean clothes and bed linen. Simply put, the first sisters were laundresses first, and then sisters in the modern sense of the word. However, in subsequent Charters of military hospitals and regulations of civilian hospitals in the 20s and 30s of the 18th century, the nature of women's sanitary care was increasingly specified and clarified.
In 1722, by Decree of Peter I, hospitals in St. Petersburg, Kotlinsk and Revelsk were ordered to have one “old woman” and her assistant to supervise the workers and linen.
The concept of "oxbow" has a double interpretation in this context. In Peter's times, an elderly woman or a nun was called an old woman. The elder woman’s duties were to monitor the behavior of women in the hospital. The constant presence of a woman in male society was still considered an extraordinary phenomenon and caused a lot of discussion, and therefore only the preservation of high morality in hospitals could guarantee the further development of female nursing care.
In subsequent decrees, the functions of the “old lady” were specified. So, in 1735 in the “General Regulations on Hospitals” ( Complete collection laws of the Russian Empire, 1830. v. 9) it was written: “To have female workers in hospitals to wash the dresses and all the linen of sick people. To supervise the linen and the female workers, to have in each hospital one matron and one assistant from old widows or good married wives, who bear the praise of their good condition, and in this paragraph the mentioned workers are kept in strong contempt, so that not a single one of them could have similarities and talk with young single doctors and students, and with the sick or with guard soldiers or with guards and strictly ensure that, besides those mentioned, other women (no matter what rank they may be) do not enter the hospital..."
In addition to supervising the workers, the duty of the “old woman” and her assistant was to “keep an eye on the cleanliness of the patients’ rooms and linen.”
Attempts to create a women's service in hospitals were temporary and did not receive sustainable development. This inertia is largely explained by the fact that after the death of Peter I in 1725, opponents of his reforms came to power. The concept of “women's service in military hospitals” continued to exist in state decrees and hospital regulations, but in practice it was almost forgotten. (1)
Nursing in the second half of the 18th century. The reign of Maria Feodorovna.
In the mid-18th century, women's nursing care began to be provided in civilian hospitals.
In 1776, the Catherine Hospital with 150 beds was created in Moscow. The hospital staff included a chief doctor, one doctor, two assistant doctors and 24 male and female nurses.
“In the reports of auditors appointed by the medical board for inspection for 1785, it is noted: “For preparing food, for washing linen and keeping the beds clean, there are a sufficient number of female soldiers (soldiers’ wives) at the hospital and decent pay is made to them. These (i.e., other, different) women are used to serve the sick, for whom, due to the nature of their illnesses, their care is decent."
So, women's work caring for patients in hospitals is beginning to find recognition. So far this labor is unskilled. However, we are already talking about special education for midwives, that is, midwives, who have existed among the people at all times. In 1754, the first midwifery schools were established in Moscow and St. Petersburg. In 1764, the first obstetric hospital was created.
At the beginning of the 18th century, midwives trained abroad appeared in Moscow. In 1754, when Russia created its own midwifery schools, several copies of a book on obstetrics by the Swedish professor Horn were issued to students. At the same time, a draft “oath of midwives” was sent to the Senate. According to this oath, the midwives pledged: “When I am in demand, I will immediately go day and night, showing all possible diligence and diligence... If the homeland lasts, it will be in vain not to persuade or force me to suffer, but I will wait for the present time, and at the same time, words, oaths, drunkenness, obscene jokes, discourteous speeches and other things are completely abstained..."
And on January 30, 1797, by a special decree, the position of midwives was introduced in all provincial and district cities of Russia.
In 1763, a hospital with 25 beds was opened in Moscow, named Pavlovskaya in honor of the future Emperor Paul I. Male patients were cared for by soldiers sent from the Military College. To care for the female sick, women were hired from among the soldiers' wives. “In the Pavlovsk hospital in Moscow, to care for the sick, the staff was supposed to have female nurses from the wives and widows of hospital soldiers. One of them was intended to examine sick women and carry out simple procedures. Later, the Pavlovsk hospital decided to hire only female nursing staff and cooks." (1)
Also in 1763, the famous Russian educator I. I. Betskoy proposed creating a system of institutions in Russia for the education and professional training of foundling children. The idea was approved by Empress Catherine II. She published a manifesto on the creation of an orphanage in Moscow on a charitable basis and was the first to contribute 100 thousand rubles. The institution was designed for 500 children, but usually it housed about 1,400. The rules for admitting children to the home were as follows:
"1) to accept into it children who were either born secretly or came from poor and poor parents, and through this save them from untimely death; 2) to raise these children for the benefit of the state; 3) to accept poor women for whom the time has come to give birth, so that they in that house will be freed from their burden." In 1770, an educational home with similar goals was founded in St. Petersburg.
The correct organization of the work of educational homes for the education and professional training of their pupils gave positive moral and material results. Summing up the charitable activities of educational homes, Empress Maria Feodorovna, under whose control their work was carried out since 1797, wrote: “Since the educational homes have already reached the point that income significantly exceeds all expenses, the time has come to use this excess for distribution The main duty of Orphanages is to do good to suffering humanity." Such a “charity for suffering humanity” was the organization of the construction of a hospital for the poor. (3)
Thus, in 1803, on the initiative of Empress Maria Feodorovna, the so-called “Widow's Houses” were established at educational homes in St. Petersburg and Moscow - shelters for poor widows left without a means of subsistence. According to the idea of Empress Maria Feodorovna, a system of constant care for elderly and sick widows was to be created within the walls of the Widow's Houses. To bring the idea to life, it was planned to have permanent staff. Thus, to care for the elderly and sick, a special group of women was recruited from among widows who had already worked in other charitable institutions of the empress for at least 15 years. Women received a special name - “compassionate widows”. Over the years, the Widow's Homes housed different numbers of patients. But, as a rule, there were always about ten people in care for one compassionate widow.
Very soon, the organizers of the Widow's Homes realized that the work of compassionate widows could be used not only in caring for the elderly residents of the Widow's Home, but also in the hospital. Thus, at the Moscow Widow's House (and at the beginning of its existence it was located in a building on the corner of Lefortovo Street and Proezzhey Lane in Moscow), a Hospital for the Poor was specially built and opened in 1806. From then on, “sick people of every condition, sex and age, of every nation, the poor and needy (and not just elderly widows) could receive the supervision of compassionate widows.” On the one hand, compassionate widows continued to fulfill their main responsibilities of caring for the elderly inhabitants of the Widow's House, on the other hand, they were given the opportunity to care for the sick in the hospital and at home and receive payment for their work.
At the same time, the organizers of the Widow's Homes already understood that only trained personnel should and could properly care for the sick. The next step of Empress Maria Feodorovna was the creation of a training course on professional medical training for compassionate widows. The St. Petersburg Widow's House became the experimental base for the implementation of this idea. (2)
In 1814, by order of Empress Maria Feodorovna, women from the St. Petersburg “widow’s house” were invited and sent to the hospital on a voluntary basis for “direct assignment” to walk and look after the sick.
After a year-long trial, on March 12, 1815, 16 of the 24 widows were sworn in, and the Empress placed a special sign on each initiate - the “Golden Cross”, on one side of which was written “compassion”. In 1818, the Institute of Compassionate Widows was created in Moscow, and special courses for nurses began to be organized at hospitals. (4)
Since January 1818, duty of compassionate widows (17 people) was established at the Moscow widow's house.
The clothes of compassionate widows differed from the clothes of the other inhabitants of the widow's house - they wore a brown dress. For 2 weeks of duty in the hospital, they received 1.5 rubles in silver and food according to a special schedule. Compassionate widows could be sent to private homes to care for the sick and had the right to receive monetary compensation for their work. After 10 years of conscientious work, the widow received an annual reward - 45 silver rubles, after 25 years - 90 rubles.
The Institute of compassionate widows existed in Russia until 1892, and then was abolished. He was the prototype of the communities of sisters of mercy, which began to be created in Russia in 1854. During the period of their activity, compassionate widows left a good reputation for themselves in the field of mercy and caring for the sick. (3)
The first guide to nursing. Christopher von Oppel.
In 1822, Russia's first manual on caring for the sick was published in Moscow. Its full name is as follows: “Guide and rules on how to care for the sick, for the benefit of everyone involved in this work, and especially for compassionate widows, who have especially dedicated themselves to this title.” Author of the manual - chief physician Moscow Hospital for the Poor Christopher von Oppel is considered the founder of the scientific base of nursing in Russia. He began work on the “Manual” in 1818, when he led a theoretical and practical course for compassionate widows undergoing testing at the Moscow Hospital for the Poor. And he finished it three years later, combining in the book the experience of Russian compassionate widows, nurses, midwives and his own medical observations on caring for the sick.
“Without proper walking and looking after the sick, even the most skillful doctor cannot achieve little or no success even in restoring health or averting death,” von Oppel explains the reason for his leadership. “And therefore this subject deserves special attention from the benevolent Government, about the lives of citizens caretaker: for an honest and knowledgeable attendant is as necessary and useful for the State as a skilled midwife.” Further, von Oppel states that it is necessary to publicly take measures “in order to teach, instruct and prepare such people with a special education, especially by establishing a special class or rank among them.” (2)
This was the first guide to caring for the sick in Russian, taking into account the experience of Russian nurses, compassionate widows, and midwives. The book included 5 sections, 24 chapters and 231 paragraphs. Justifying the need for instructions, X. Oppel noted: “...many patients die only because they did not have proper supervision,” and then gave casuistic examples: “There have been such sad cases... that people apparently died prematurely alive were buried." The first section of the manual contains general provisions, the role of a compassionate widow in caring for the sick, and the requirements for her: “The caregiver is the only necessary instrument, on the fidelity and accuracy of which the success of treatment depends.” The author also emphasizes the qualities necessary for a “walker” - philanthropy, attentiveness to the patient, patience, honesty, compassion, kindness, patience; describes the arrangement of the room, the things the patient needs, the requirements for the bed and bed of the patient, the features of his care, including 58 specific points.
The second section contains, for example, the following headings: general precautions; drinking of the patient; liquid medicines; solid drugs; laxatives; emetics; enemas or washes; laxative icicle or candle; baths; mustard plasters; poultices, rubbing, smearing with ointment, Spanish flies and applying leeches.
The third section of the book is devoted to the peculiarities of care for various diseases - fever, weakness and fainting, nosebleeds, bedsores, the fourth - methods of preparing medications by the person caring for the patient.
For decades, the Manual compiled by von Oppel was regarded as a reference textbook on nursing. From a modern perspective, the 1822 Manual not only provided medical and technical knowledge for nursing, but also formed the professional philosophy on which modern nursing is based. (2)
The emergence of communities of sisters of mercy in Russia.
In 1844, in St. Petersburg, on the initiative of Grand Duchess Alexandra Nikolaevna and Princess Theresa of Oldenburg, the first Holy Trinity community of sisters of mercy in Russia was founded. In the community they not only cared for and educated, but also taught nurses the hygienic rules of caring for the sick and some medical procedures.
According to the Charter, widows and girls between 20 and 40 years of age of all classes and religions were accepted into the community, but since 1855 - only Orthodox Christians. All applicants were given a one-year probationary period, then a ceremony of acceptance into sisters of mercy took place in a solemn atmosphere. After the liturgy celebrated by the Metropolitan of St. Petersburg, a golden cross was placed on each sister accepted with an image on one side of the Most Holy Theotokos with the inscription “Joy of all who mourn,” and on the other with the inscription “Mercy.” The one being accepted as a sister took an oath in which there were the following words: “...I will carefully observe everything that, according to the instructions of the doctors, will be useful and necessary for restoring the health of the sick people entrusted to my care; everything that is harmful to them and forbidden by doctors to be removed from them in every possible way.”
According to the Charter, sisters of mercy were not supposed to have their own clothes, furniture, or money. “Everything that a sister can receive for her services in gifts or money,” the Charter said, “belongs to the community. If there were violations, the sister was expelled from the community according to the Charter, but there was no such case in the history of the community.
“If a sister satisfies her purpose, she is a friend of his family, she alleviates physical suffering, she sometimes calms mental anguish, she is often dedicated to the sick in his most intimate worries and sorrows, she writes down his dying orders, guides him to eternity, takes his last breath. How much patience, resourcefulness, modesty, firm faith and ardent love is needed for this. There is a deep meaning in the requirement that the work of a nurse be free of charge, since there is and cannot be any earthly payment for the provision of her services.” In 1847, the title of Sisters of Mercy was awarded to the first 10 women who received training for the community. The community existed on its own charitable organizations. However, the Crimean War of 1853-1856 made its demands. (4)
Nursing during the Crimean War (1853-1856).
During the Crimean War, the Grand Duchess became one of the founders of the Holy Cross community of sisters of mercy - the predecessor of the Russian Red Cross Society. Morally supported in her thoughts by Pirogov, despite secret and dirty ridicule and obvious opposition from the highest military authorities, she managed to convince Emperor Nicholas of the usefulness of the new endeavor and created the first military community of sisters of mercy.
“Her (the Grand Duchess’s) main concern was to give the community that highly religious character, which, inspiring the sisters, would strengthen them to fight all physical and moral suffering.” For the cross that the sisters were to wear, Elena Pavlovna chose St. Andrew's ribbon. On the cross there were inscriptions: “Take my yoke upon you” and “You, O God, are my strength.” Elena Pavlovna explained her choice like this: “Only in humble patience do we receive strength and strength from God.”
The charter of the Holy Cross community was approved on October 25, 1854. On November 5, after mass, the Grand Duchess herself put a cross on each of the thirty-five sisters, and the next day they left for Sevastopol, where Pirogov was waiting for them. Then other detachments followed. This is how the world's first front-line community of sisters of mercy arose.
At the same time, the Grand Duchess issued an appeal to all Russian women not bound by family responsibilities, calling for help for the sick and wounded. The Holy Cross community united patriotic Russian women from all walks of life; Along with the wives, widows and daughters of titular and collegiate councilors, nobles, landowners, merchants, officers of the Russian army and navy, there were also simple illiterate women.
Her Palace, known now as Mikhailovsky, turned into a large warehouse of things and medicines.
In St. Petersburg and Moscow, more and more women announced their decision to go to Crimea to the theater of military operations. The 2nd detachment of 13 people arrived in Sevastopol on January 25, 1855, it was led by the elder sister M. Merkulova. A few days later, 8 sisters of the 3rd department arrived under the leadership of Sister E.M. Bakunina; April 9 - 19 more sisters of the 4th department, led by Sister Budberg. Ekaterina Mikhailovna Bakunina (1812-1894) - “the ideal type of sister of mercy” - received especially high praise.
The main place of selfless work of the sisters of the Community was besieged Sevastopol. Small detachments of sisters worked in 10 other cities: Bakhchisaray, Simferopol, Perekop, Kherson, Nikolaev, etc. Almost all of them suffered from typhoid fever or other epidemic diseases, some were wounded or shell-shocked.(5)
N.I. Pirogov, under whose leadership these first sisters of mercy worked, in one of his letters describes their activities in great detail. On his initiative, for the first time in the history of military field surgery, nurses and doctors were divided into four groups. The first group was responsible for sorting those arriving by severity of wounds, and those who needed urgent surgery were immediately transferred to the second group. The third group cared for the wounded who did not require urgent surgical treatment. The fourth group, consisting of only sisters and a priest, cared for the hopelessly ill and dying. Finally, two housewife sisters were busy distributing wine, tea or broth to the wounded. The housewife sisters kept all the provisions. This was the first “specialization” among sisters, taking into account the level of their knowledge and abilities, as well as the practical need for this type of activity.
The Crimean War showed the benefits of female care for the wounded and sick, which was carried out by the warring parties. Based on the experience of the Crimean War, N.I. Pirogov will write something that will be included in all medical encyclopedias and textbooks in the world: “War is a traumatic epidemic. Just as during large epidemics there is always a shortage of doctors, so during large wars there is always a shortage of them.” He became convinced in practice that in such a situation, in the interests of the wounded and sick, it is necessary to expand the functions of the nurse; they should be broader than those of the nurse, and the quality of medical care should be higher. And preventive measures to prevent diseases, especially infectious ones, to create conditions for recovery turned out to be so striking that, as N.A. Semashko noted, N.I. Pirogov proved that “the future belongs to preventive medicine.” This was also proven by the sisters of mercy who worked under the leadership of N.I. Pirogov in the most difficult conditions of the Crimean War.
The experience of the nurses during the Crimean War showed the following: sisters must be able to create conditions for recovery and prevent disease, “provide services for recovery”; know the signs of “changes in illness”, be able to evaluate them and provide assistance in case of sudden “changes”; know not only the name of the drugs, but also their effect and the complications they can cause: be able to keep documentation that records “changes” in the condition of the sick and wounded, comments and suggestions for their care. Taking into account the needs of practice, it is necessary to separate the functions of nursing staff - specialization (nurse giving chloroform; helping during operations; working with hopelessly sick and wounded). Sisters of mercy must be prepared to work in extreme situations (wars, disasters, epidemics, etc.). They must act as representatives and advocates for the interests of the wounded and sick. To perform these and many other functions, the nurse requires special knowledge, training and educational programs. (6)
The sisters of mercy of those years are by no means the same as nurses in the modern sense. Girls and widows of “good origin” aged 20 to 40 years (girls refused to marry in order to serve the cause) could enter the community only after a probationary period of 2 years in caring for the sick. Then they underwent special training in Red Cross institutions. They worked for free, receiving only food and clothing from the community. In 1856, at the request of the same Elena Pavlovna, a medal was minted to reward especially distinguished sisters of the Holy Cross community. At the same time, Empress Alexandra Feodorovna, the widow of Nicholas I, established a similar medal.
After the end of the war, the entire burden of expenses for maintaining the Exaltation of the Cross community fell on Elena Pavlovna, but the scope of the sisters’ activities did not decrease, but even expanded: in addition to the hospital, an outpatient clinic and a free school for 30 girls appeared in the community. (5)
The formation of the training process for nurses.
Since 1867, nursing education began to be carried out on the basis of the Russian Red Cross Society (ROSC), and communities united into schools of nurses. Of course, independent communities continued to exist, independent of the Red Cross, but in case of war they were obliged to form groups of sisters to work in Red Cross detachments in the theater of war.
In 1877-78, when the Russian-Turkish war, 1,100 nurses worked at the theater of war.
From 1880 until almost the end of World War I, the Russian Red Cross Society, and therefore the training of nurses, was under the patronage of Empress Maria Feodorovna, a Danish woman by birth, who was given a Russian name after her marriage to the Russian Emperor Alexander III.
By 1891-92, the Russian Red Cross had developed uniform rules for admission and uniform training programs for nurses. During the reign of Alexandra Feodorovna, experience outside the community training of nurses was first tested. Students paid for their own education.
The training was conducted for 1.5 - 2 years. The course consisted of a theoretical and practical section. Teaching was conducted partly in the Red Cross's own institutions, partly in military hospitals, city and zemstvo hospitals, and private hospitals.
The sisters studied the following disciplines: anatomy and physiology, hygiene, general and particular pathology, information about epidemiology, pharmacy and formulation, skin and venereal diseases, general surgery, desmurgy and the doctrine of asepsis, women's diseases, childhood diseases, eye diseases, nervous and mental diseases, massage. The practical course was devoted to general patient care and care of surgical patients, basic methods of wound dressing, minor surgery, and smallpox vaccination. Particular attention was paid to practical training: throughout the entire course of training, students had to carry out all the work of nurses in the community's medical institutions under the supervision of experienced nurses. They were also assigned to duty in hospitals - in wards and operating rooms, in outpatient clinics to assist doctors, and in pharmacies to learn how to prepare medicines.
At the end of the course, the sisters passed an exam and became subjects, in which capacity they had to serve in the community for 2 years, after which they received a certificate for the title of sister of mercy. After this, most of the sisters left the community and were sent by the Red Cross to military hospitals, public and private hospitals and to the ROKK’s own medical institutions... After the Russian-Japanese War of 1904-1905. It was decided to more intensively develop the non-community form of training for sisters of mercy. This made it possible to maintain the real size of communities in Peaceful time and have a sufficient supply of qualified nurses available during periods of hostilities. (7)
Nursing in Russia after the revolution, as well as during the Great Patriotic War.
After the revolution in Russia there were 109 communities and about 10,000 sisters of mercy. After the revolution, the Red Cross Society underwent liquidation, recognition in 1921 and revival in 1925. In 1938, the property of the Red Cross was transferred to various people's commissariats. Nevertheless, the activity of the society in the thirties was vigorous. There were GSO (ready for sanitary defense) detachments for adults and BGSO (be ready for sanitary defense) for children. Sanitary squads and medical posts arose, the population was trained in the elements of care and provision of first aid. (4)
The People's Commissariat for Education approved the training of nurses in polytechnic schools, approving sufficient basic education - 4 grades. (1921). Since this period, the profession has ceased to develop. The further development of nursing in Russia was also not easy: accelerated training of nurses for the impending war began (Rokkovsky courses); difficult years of war; post-war years of country reconstruction; the introduction of two-shift service in hospitals due to the post-war shortage of nurses; the introduction of a team contract, when a nurse can replace a nurse, a housekeeper, or a barmaid; lack of international contacts. All this reduced the prestige of the profession and did not provide the opportunity to improve it. (8)
After the Civil War, many nurses of the Red Cross Society took part in the fight against hunger. They were sent to the Volga, Kyrgyzstan, Siberia and Turkestan large quantities medical and nutritional teams, which, using funds raised in the country and abroad, fed and provided medical care to more than 120 thousand people every day. When eliminating the consequences of the famine in 1922-1923. The Soviet Red Cross carried out work in two directions: the institutions of the society continued to provide medical and nutritional assistance to children - the part of the population most affected by hunger; In the areas most affected by famine, rural outpatient pharmacies were organized for the first time.
In 1922, the year the USSR was founded, the Red Cross Society was reorganized into the Union of Red Cross and Red Crescent Societies (SOKK and KP).
In 1924, when famine engulfed a number of central provinces of the RSFSR, North Caucasus and Crimea, the Red Cross Society again came to the rescue, providing medical care to more than 5 million residents of these territories.
During this period, the Red Cross Society - as a public organization - used its capabilities where practical health authorities could not manage with their own funds. The activities of 179 (mainly tuberculosis and dermatovenerological dispensaries) out of 757 medical institutions of the Red Cross Society were aimed at combating social diseases. There were 68 institutions for the protection of motherhood and childhood belonging to the Red Cross Society.
On June 6, 1925, by resolution of the All-Russian Central Executive Committee and the Council of People's Commissars of the RSFSR, a new “Regulation on the Red Cross Society” was approved, according to which Red Cross institutions should create schools and courses for the training of medical workers. In 1926, nurses began to be called nurses, in 1927 the first sanitary squads were created, and starting from 1928, systematic training of nurses began.
During this period, the executive committee of the Union of Red Cross and Red Crescent Societies organized “courses for reserve nurses.” Training in these courses was conducted free of charge, and those who completed them received a certificate giving the right to perform the duties of nurses in wartime. In 1934, the first “Manual for courses for reserve nurses” was published.
During the military conflicts between Russia and Japan at Lake Khasan (1938), on the Khalkhin Gol River (1939), as well as during the war with Finland (1939-1940), nurses showed heroism and courage in performing their duties. professional responsibilities.
During the Great Patriotic War The need for nurses for the needs of the front and rear increased sharply, so the People's Commissariat of Health of the USSR took measures to accelerate the training of specialists with secondary medical education. In the first 6 months of the war alone, the Red Cross Society trained 106 thousand nurses and 100 thousand sanitary workers. And during the entire period of the war, Red Cross organizations trained more than 280 thousand nurses, about 500 thousand sanitaries and 36 thousand nurses. (9)
370 thousand people have been trained in first aid clubs. The training of nurses in Leningrad did not stop during the siege.
A network of medical schools and courses was maintained and operated in the city, in which the training of nurses was carried out in several areas: primary training, advanced training, retraining of orderlies, externship for persons with incomplete secondary education. During the difficult blockade winter of 1941-1942. The mobilization of young people to the front and the evacuation of residents led to the fact that out of 19 medical schools, 11 remained. In 1942, medical schools graduated 960 nurses, mostly after six months of training. At the beginning of 1942, another 68 training groups for nurses of the Red Cross Society were organized in Leningrad, in which about 2 thousand people were trained on the job.
A number of large hospitals opened advanced training courses for nurses as branches of medical schools. Many nurses were drafted into the active army. At the front, they worked as sanitary instructors of companies, in regimental and divisional medical centers and hospitals. Here, nurses showed exceptional cordiality towards the wounded and sick, a willingness to give all their strength and even their lives in the performance of their duties. The fates and exploits of many sisters are similar. All of them, on the battlefields and in days of peace, without sparing themselves, sought to alleviate human suffering; the main thing in their lives was philanthropy. (10)
In 1942, the magazine “Nurse” began to be published. In the fifties, medical schools were reorganized into medical schools, and a system of secondary education was created special education. (4) The experience of the Great Patriotic War, as well as the Crimean War, once again showed that nurses performed a number of medical functions in the interests of the sick and wounded. They have proven that they can work independently, especially when carrying out preventive, anti-epidemic and rehabilitation measures. Nurses were closer to the sick and wounded; they were more often on the battlefield. Therefore, it is no coincidence that among the medical workers awarded the highest government award - the title of Hero of the Soviet Union, there were more nurses than doctors.
By 1995, the International Committee of the Red Cross had awarded 46 women in our country the Florence Nightingale Medal. This medal recognizes nurses for exceptional dedication and bravery in caring for the wounded and sick in both war and peace. For the first time, the Soviet Red Cross nominated candidates for the F. Nightingale medal in 1961. Then the medal was awarded to two participants in the Great Patriotic War: a guard lieutenant colonel of tank forces, a writer, Hero of the Soviet Union, Muscovite Irina Nikolaevna Levchenko and a surgical nurse, the chairman of the primary organization of the Red Cross at the Leningrad factory "Skorokhod" of Lydia Filippovna Savchenko. In 1965, this medal was awarded to a nurse, Hero of the Soviet Union, Zinaida Mikhailovna Tusnalobova-Marchenko. And then every 2 years, from 3 to 6 Soviet women received medals.
Many orderlies and sanitary instructors were awarded the highest soldier's award - the Order of Glory, which was awarded only to privates and sergeants. 18 medical workers were awarded Orders of Glory of all three degrees, and among them one was a female medical instructor, Matryona Semyonovna Nechiporchukova-Nozdracheva. The chronology of her exploits is as follows. In August 1944, during 2 days of fighting, she provided assistance to 26 wounded; under enemy fire, risking her life, she carried a wounded officer to a safe place and evacuated him to the rear. For these exploits she was awarded the Order of Glory, III degree. Matryona Semyonovna was awarded the Order of Glory, II degree, for saving the lives of the wounded in the winter of 1945. For two days she guarded more than 30 wounded, fed and watered them, bandaged them, and only on the third day evacuated them to the hospital. (10)
The current stage of development of nursing.
In 1963, the question of the feasibility of opening medical schools at large multidisciplinary hospitals, which are also the clinical bases of higher medical educational institutions and research institutes of the country, was finally resolved. This made it possible to bring the training of nurses closer to their place of future work. In the same year, advanced training courses for paramedical workers began to be created at large medical institutions.
The socio-economic reforms that began in the country in the late 80s required a reorganization of the system of providing medical care to the population.
The training system, the definition of the functional responsibilities of a nurse, and the development of quality standards for her work should be determined by the WHO provision that nursing is an independent discipline. Nursing care is considered as an organized multifaceted process aimed at the individual, with his physical and psychosocial problems. This approach to nursing, adopted in developed countries world, requires the training of specialists of a special level - nurses with higher education.
Despite the different economic situation, different political systems, culture and language, there are universal factors that influence the development of nursing in every country. Among them, there are three main ones: the predominance of women among nursing professionals; the predominance of the role of curative medicine over preventive medicine; lack of representation of nurses in legislative and executive bodies.
On November 5, 1997, a government decree approved the “Concept for the development of healthcare and medical science in the Russian Federation,” according to which the development of primary health care (PHC) is one of the main directions in improving the organization of medical care.
Today, healthcare needs a nurse who is not only good performer professional responsibilities, but also creative personality, which would take into account the psychological characteristics of the patient and even the home environment and family relationships.
An important event in the history of nursing was the creation in 1992 of the Association of Russian Nurses. It was organized on the initiative of nurses as a non-governmental professional organization. The “Project for the Development of the Association of Russian Nurses” identified the following areas of work for the Association: increasing the role of the nurse in the healthcare system, increasing the prestige of the profession; improving the quality of medical care; dissemination of best practices and scientific achievements in the field of nursing; revival of traditions of nursing; protecting the interests of nurses in legislative, administrative and other bodies; organizing the collection of information on nursing, its analysis and dissemination; cooperation with international organizations and government agencies. The immediate objectives of the Association’s activities were:
Participation in the work of expert and problem commissions of the Ministry of Health of the Russian Federation;
Strengthening ties between regional Nurses Associations of Russia;
Publication of the "Bulletin of Nursing Associations of Russia";
Supporting relations with national Associations and the International Council of Nurses;
Development of documents for joining the International Council of Nurses.
The first president of the Association of Russian Nurses, V. A. Sarkisova, speaking about its tasks, emphasizes that there are still many unresolved problems. This also includes the status of a nurse, who must have high professionalism and be an equal partner in the medical team. This also includes the issue of professional risk insurance and provision of preventive measures against infectious diseases for nurses in intensive care, operating rooms, anesthesiology and hematology departments. This includes a revision of work standards and a significant improvement in the socio-economic situation of nurses, support and technical personnel. One of the main objectives of the Association was to attract the attention of the Government to the problems of nurses, the solution of which determines the further development of nursing in Russia.
In June 1996, the All-Russian Conference on Nursing took place in St. Petersburg. The conference was organized by the Association of Russian Nurses and the Ministry of Health of the Russian Federation. It discussed pressing issues of nursing practice and nursing education. The association has been recognized as national organization, representing and protecting the interests of Russian nurses.
This event went down in the history of the country as a conference at which the draft of the first “Code of Ethics for Nurses”, developed by the Association of Nurses of Russia, was adopted. The adoption of this document gives hope for a complete revival of moral and ethical principles in medical practice. The code reflects the positive and negative results of scientific and technological progress in healthcare, issues of increasing the risk of developing iatrogenic diseases, features of the nursing reform ongoing in the country and other aspects related to the activities of nurses. (eleven)
3. Conclusion
Thus, by considering this topic in detail, we can understand in detail the features of the development and establishment of nursing in Russia. Based on the given life episodes and the names of people who made a great contribution to the development of nursing, we can conclude what spiritual qualities possessed by people who decided to devote their entire lives to medicine. We see that the process of formation is uneven, there are periods of rise and decline, but the hardest thing was for the domestic nursing industry during the years of various wars. The Crimean War and the Great Patriotic War became especially significant in this regard. However, we can also note that it was precisely such emergency situations that most contributed to the intensive development of nursing. 3. V.P. Romanyuk. Golden Korets / Sisterhood / History of nursing service in Russia / Organization of a system of care for the sick / V.P. Romanyuk, V.A. Lapotnikov, Ya.A. Nakatis [Electronic resource], - Access mode: http://www.sygeplejersken.dk/nh/manuel/CHAPTER7.htm http://medic.vgrad.net/articles/nursing_process/1263147868
11. V.P. Romanyuk. Golden Korets / Sisterhood / History of sisterhood in Russia / The state of the merciful sisterhood movement in Russia on modern stage(end of the 20th - beginning of the 21st century) / V.P. Romanyuk, V.A. Lapotnikov, Ya.A. Nakatis [Electronic resource], - Access mode: http://www.randd.ru/Miloserdie_5.htm
12.Dina Yafasova. Photo gallery / Dina Yafasova [Electronic resource], - Access mode: http://www.sygeplejersken.dk/nh/manuel/NEW-49.JPG
13. A nurse at the bedside of a wounded man. Photo 1906. :: Encyclopedia of St. Petersburg [Electronic resource], - Access mode: http://www.encspb.ru/ru/bigimage.php?kod=2803991655
14. Sister of mercy. Photo. Between 1914 and 1917. :: Encyclopedia of St. Petersburg [Electronic resource], - Access mode:
When people talk about the history of medicine, they often remember the names of great doctors: Hippocrates, Galen, Ibn Sina, Pirogov, Botkin, Sklifosovsky, Bekhterev, Ilizarov and many others, as well as the history of the development of diagnostics, pharmacology, deontology and other components of healing. At the same time, they completely forget about the role of nurses, paramedics, and midwives.
When and how did nursing appear as a concept and as a practice of caring for patients? Familiarization with a number of historical and medical works by domestic and foreign authors allowed us to conclude that nursing is older than medicine and civilization. These are materials of a paleopathological nature, identified during archaeological excavations and indicating that people of the Mousterian period (about 100 thousand years BC) survived fractures, wounds, and ritual trepanations thanks to nursing.
As a specialty, nursing was formed in the middle of the 19th century, almost simultaneously in Russia and the West, and by the end of the 20th century. flourished in the USA and other countries. In Russia, it appeared as one of the lowest paid and most unprestigious professions.
Attempts to understand the reasons that gave rise to the current situation and hinder the way out of it lead us to the need to trace the history of the development of nursing in the world in general, and in Russia in particular.
What does history give us? It allows us to learn about the events of the past, helps to identify the connection between distant events and our lives. History gives us a sense of belonging and provides the opportunity to discover our roots in those civilizations and peoples that no longer exist. It gives us a chance to avoid mistakes by learning from the past.
Getting to know the history of the development of nursing turns us to the roots of this unique profession, introduces us to the factors that influenced and influence development and establishment of nursing throughout the world and in our country.
The study of history is intended to recreate what has been forgotten, to recall what has survived and call for its preservation, to pay tribute to those who, to the best of their ability and ability in accordance with the spirit of the time, did good deeds in the name of love for people. Discovering the events of the distant past, we discover the names of a whole galaxy of philanthropists. Representatives of various classes gave to those in need what they had: some - fortune, others - strength and time. These were people who received satisfaction from the consciousness of their own benefit and service to their fatherland. They left us monuments of kindness and mercy. Our task is to remember and preserve them.
On the development of nursing abroad
Approximately the first five centuries AD. Nursing care consisted mainly of performing hygienic measures and creating comfortable conditions for the needy, homeless and sick. It was provided mainly by early Christians, both individually and within the framework of the Christian Church. IN Ancient Rome For a long time, anyone could even treat the sick. But, as a rule, this occupation, “despicable” from the point of view of the patricians, was the lot of slaves of Greek or Jewish origin.
In subsequent centuries, as Christianity established itself as the dominant religion in Europe, the Church took upon itself the care of the weak and sick. This responsibility rested with deacons and deaconesses. Even entire orders of knighthood appeared, devoting themselves entirely to care.
In 1633 in Paris St. Vincent de Paul and St. Louise de Marillac founded the Daughters of Charity congregation. It was the first open religious women's organization that was involved in charity work. Her activities, initially aimed at caring for the poor at home, eventually began to include teaching poor children, working in hospitals, and caring for the wounded. By the beginning of the 21st century. this congregation grew into the largest religious women's organization in the world.
All these people who helped children, the weak and the sick, these knights on the battlefield, monks and deaconesses stood at the origins of nursing, which turned into a profession as a result of long-term efforts to meet the needs of society.
Nursing thus originated within the traditional model of human care. The honor of creating it as a profession belongs to the English sister Florence Nightingale (1820-1910). F. Nightingale was an extraordinary person, as evidenced by her biography.
She was born on May 12, 1820 in Florence, where her parents temporarily lived. She owed her education mostly to her father, who taught her Greek, Latin, French, German, Italian, history, philosophy, and mathematics. On February 7, 1837, she “heard a voice” about her special mission, but only nine years later did she understand what it was. F. Nightingale wanted to study the organization of patient care directly in hospitals, but she was not allowed. Then she began collecting information from official documents, and within three years, influential friends began to consider her an expert in health care. In 1846 they sent her the “Yearbook of the German Protestant Organization of Deaconesses.” This organization operated a school that trained girls of good character to care for the sick. Florence entered it at the age of thirty and completed the full course of study.
The hospitals of that time, which mainly treated the homeless and the poor, employed only women of questionable behavior who were not hired for any other work. Wealthy patients were cared for at home by family members and servants.
In addition to hospitals, care facilities for wealthy people began to appear. In 1853-1854. in London, F. Nightingale worked as the head of a similar institution for the care of sick noble women. She called her institution a “little wormhole” and yearned for broader activities. The Nightingale family had a negative attitude towards Florence's activities.
When the Crimean War (1853-1856) broke out and allied British and French armies landed in the Crimea, the British were particularly alarmed by the state of affairs in the army related to the state of care for the wounded. Florence immediately decided to volunteer, taking with her a small detachment of sisters. On November 5 they arrived at the site; there were no conditions for treatment or care there. One pint of water per day was allocated for all needs. The doctors were initially hostile, and nurses were not allowed in the wards. It wasn't just the doctors who were against it. One of the European newspapers of that time wrote that Nightingale and her associates ignored the social laws of decency and began to help the suffering, while directing their activities not to helping people of the same sex, but mainly to caring for wounded soldiers. But the situation soon changed: thanks to care, the mortality rate among the wounded dropped from 50 to 2%.
Nightingale had great powers. Using the money she brought with her, she organized the provision of the hospital with everything necessary, and also dealt with administrative issues and correspondence. By the end of the war, Florence became the leader of all nursing units that worked in British hospitals in the Crimea. Florence Nightingale returned to England as a national hero.
Upon returning home, she decided to direct her activism towards improving the living conditions of British soldiers. As a result, in May 1857, a meeting of the commission on health problems in the army was held, at which Nightingale made a report. As a result of the work of the commission, the Army Medical School was created in the same year.
The Indian popular uprising (1857-1859) against the British colonialists also attracted the attention of F. Nightingale. Another royal commission was appointed, the result of which was the creation in 1868 of the Department of Health in the Ministry of Indian Affairs. Nightingale had never been to India, but at the same time she was considered a recognized expert on this country. Even government officials consulted her.
During her long life, F. Nightingale wrote about 150 books and monographs. The most significant work, which has not lost its relevance today, remains her small work “Notes on Nursing: What it is and What it is not”, 1860, where the main attention is paid to the issues of full-fledged nursing. Nightingale believes that the goal of care is to create optimal conditions for the patient's recovery. For the first time, such an area of nursing as caring for the healthy has been highlighted. By attracting public interest to environment, as a set of external and internal factors affecting health, Nightingale draws attention to the need to change it.
In the 19th century The work of a nurse was not considered something so difficult that it required special training. Although even then there were schools of sisters in the communities. For example, the school in Kaiserswerth (Germany), from which Nightingale brilliantly graduated in the early 50s. Florence emphasized that nursing, as a profession, is inherently different from medical practice and requires special knowledge, different from medical knowledge, and that the management of hospitals should be undertaken by specially trained nurses.
Nightingale convinced the public that a nurse often plays a decisive role in saving a person’s life, and therefore must have special knowledge and skills. On June 24, 1860, with the money raised in honor of the anniversary of F. Nightingale’s work in Crimea, the world’s first secular School for nurses was opened at St. Thomas’s Hospital in England. Miss Nightingale designed for
This school has a detailed training plan, a daily routine for students (of whom there were ten at first) and rules of behavior. She believed that the training of nurses should be carried out by specially trained sisters (it should be noted that among doctors, the establishment of a school of nurses was met with hostility). Over the following years, not without her active role, many schools were opened to train midwives and nurses to work in hospitals for the poor. Thanks to Nightingale, the education of sisters ceased to be a monopoly of the church.
From 1857 Florence lived mainly in London. The illness confined her to bed. Without rising from her couch, she received many visitors (who either passed on information to her or came for her), and carried on a huge correspondence (she wrote about 12,000 letters).
There is no information that Florence had any organic disease. Her illness was most likely neurotic in nature, perhaps with a dose of mystification. Nightingale worked day and night. Gradually her vision began to fail. In 1901 she became blind.
In 1907, King Edward VII awarded her Britain's highest honor, the Order of Merit. This is the first time a woman has been given this honor.
Florence Nightingale died in 1910. And in 1911, a monument to her was unveiled in London. At the opening ceremony, the mayor of London noted that the monument was erected to commemorate the highest merits of the great Englishwoman.
In 1872, nursing schools were opened in Philadelphia and Boston in the United States. Linda Richards, who graduated from Boston High School in 1873, became the first certified American sister. In 1874, Mack Training School was opened in Ontario (Canada). In 1879, Mary Eliza Mahoney became the first black woman to earn a nursing degree. The British Nursing Association was founded in 1887, and the American Nursing Association (ANA) in 1897.
In 1899, the International Council of Nurses (ICN) was created as the first professional organization for women. Today, MSM is actually the largest and most authoritative international professional organization, including 127 states. President of the MSM in 1997-2001. There was a Danish sister, Kirsten Stalkhnet. In 2001, the English nurse Christina Hancock was elected president of the ISM, and in 2005, the Japanese nurse Hiroko Minami.
On the history of the development of nursing in Russia
The most complete analysis of the history of the development of nursing in Russia presented in the works of G.M. Perfileva and in the monograph “History of Nursing in Russia”. G.M. Perfilyeva believes that the formation of secular nursing took an original path, without the noticeable influence of European medicine. It is Russia that has priority in shaping the idea of nursing care as a special form of medical activity that requires special theoretical training. As an example, she refers to the textbook of the Russian surgeon, chief physician of the Mariinsky Hospital for the Poor, Christopher von Oppel (1822). Almost half a century later, many of his ideas were reflected in the works of F. Nightingale. But international isolation deprived both Russian sisters of the opportunity to join international experience and foreign colleagues to get acquainted with our achievements.
Summarizing the history of the development of nursing in Russia in the 16th-20th centuries, we tried to trace its main milestones (Table 1-1). For analysis, we will conditionally highlight four stages of the development of nursing in Russia: pre-Petrine; 1701-1917; 1918-1976; from 1977 to the present day.
Pre-Petrine period of development of nursing
In Rus', court doctors appeared already in the 10th century. at Kyiv princes. These were mainly monks of the Kiev-Pechersk Monastery. Hospital wards were created at the monasteries. The place where pain puts a person “prone” began to be called hospitals. One of the first mentions of a hospital hospital in Rus' is associated with the name of Princess Olga, who organized a hospital where women began to care for the sick. The monasteries taught the art of healing and medical culture to the daughters and widows of noble people. Hospital buildings, as a rule, were located outside the monastery walls, with laundries, baths, vegetable gardens, and cemeteries adjacent to them. The rich were obliged to take care of the comfortable existence of hospitals. During the days spent undergoing treatment in the hospital, the poor worked on arable land, in the fields, and as a carriage driver.
Table. Main milestones in the development of nursing in Russia in the 16th-20th centuries.
Before the Tatar invasion, the chronicles mention hospitals in Kyiv, Pereyaslavl South, Smolensk, Vyshgorod, Chernigov, Novgorod, Pskov, Volyn, Galician Rus, etc.
Characterizing the state of health care during the period of the Mongol-Tatar yoke, Russian medical historian N.P. Zagoskin wrote: “Laid out in the XII-XIII centuries. The beginnings of secular medicine are stalled in this era, ... medicine is completely withdrawn into monasteries...” But the rich traditions of traditional medicine were not lost, and handwritten works continued to spread. They gave advice on the use of medicinal herbs, food hygiene, and the use of baths. From the chronicle we know about Eupraxia, born in 1108, the granddaughter of Prince Vladimir, who deeply studied traditional medicine and left the first domestic medical work called “Ointments.” It is devoted to issues of physiology, hygiene, propaedeutics, and the prevention of certain diseases.
In 1551, at the Stoglavy Cathedral, the intention to open state hospitals and almshouses was first expressed, since monastery almshouses cannot “look after and treat everyone.” But, as we will see below, the first state hospital was opened in Moscow in 1707.
Thus, in Muscovite Rus', the participation of women in the fate of the sick was manifested in various types of charitable activities carried out by representatives of various classes.
Development of nursing in 1701-1917.
Development of nursing in the 18th century. For the first time, women began to be involved in caring for the sick under Peter I (1682-1725). For example, they had to serve in educational homes created “... for the preservation of shameful babies, whom wives and girls give birth to unlawfully.” However, the issue of “charity for foundlings” was resolved only under Catherine II, who opened educational homes in Moscow and St. Petersburg in the 60s of the 18th century.
In addition to the Military Regulations of 1716, Peter I defined the responsibilities of women in caring for the sick by the “Regulations on the Administration of the Admiralty and Shipyards”. In 1728, after the death of Peter I, staff positions for women were introduced into the hospital schedule.
In the “General Regulations on Hospitals” (1735) it is written: “Women should be employed in hospitals to wash the dresses and all linen of sick people. To supervise linen and female workers, have
each hospital has one matron and one assistant from old widows or good married wives who bear the praise of good fortune, and in this paragraph keep the mentioned workers in strong charity, so that not a single one of them could have similarities and talk with young single doctors and students, also with the sick or with the guard soldiers or with the guards, and be very careful that, besides those mentioned, other women (of whatever rank) do not enter the hospital.”
But the lack of a system for organizing women’s labor in hospitals and the lack of command interest in it led to the fact that in most hospitals, the participation of women in care either ceased over time or was temporary. As a result, the sick and wounded, especially in wartime, were practically completely self-sufficient. For example, in 1808 in the Grodno hospital there were 500 patients per doctor in the complete absence of attendants medical personnel.
As noted above, the initiatives of Peter I were destined to come true only during the reign of Catherine II (1762-1796). In 1763, the Pavlovsk Hospital was established in Moscow, in which the staff was supposed to have nursing soldiers, and for women - nursing women from the wives and widows of hospital soldiers. One of them was appointed “to examine sick women in hidden places of illness and insert enemas into them” and was called a babka, or clerister.
Later, women's labor began to be used in medical institutions of the military department. In the reports of the auditors appointed by the medical board for inspection for 1785, it was noted: “For cooking, for washing clothes and keeping the beds clean, there are a sufficient number of female soldiers at the hospital, and they are paid decently. These women are used to serve the sick, for whom, due to the types of illnesses, their care is decent.”
Based on the foregoing, we can conclude that in the 17th century. care in hospitals was provided by men (retired soldiers), “side-soldiers.” In the 18th century As part of the reforms carried out by Peter I, women began to be involved in caring for the sick in civilian and military medical institutions. At first these were old women from monasteries, then wives and widows of hospital soldiers. At that time, apparently, there was no special training for nurses to care for the sick.
Service of “compassionate widows”. Some authors believe that nursing in Russia arose in 1803, when the service of “compassionate widows” appeared. This year, Empress Maria Feodorovna is establishing “widows’ houses” in Moscow and St. Petersburg - shelters for poor widows left without a livelihood. The wonderful Russian writer A.I. spent his childhood in one of these houses. Kuprina. He described his childhood memories of the common ward of the “widow’s house” in the story “Holy Lies.”
In 1813, it was decided to recruit a number of widows from the St. Petersburg widow's home to assist in raising orphans and to work as nurses in the Mariinsky Hospital for the poor.
Mariinsky Hospital in St. Petersburg is the first private charitable medical institution. The hospital has 200 beds and an outpatient clinic, 9 doctors, 12 paramedics, 14 matrons, 60 attendants, and 54 other servants.
The hospital was completely self-sufficient. The income from the greenhouse, where vegetables and fruits were grown all year round, was enough to pay the salaries of all the staff, food for the sick and medicines.
Clean and warm wards, clean and dry bed and underwear, good nutrition, regular ventilation of the premises, annual whitewashing and painting of each ward and corridors, full care and treatment provided the Mariinsky Hospital with a reputation as one of the best hospitals in Europe at that time.
The Empress developed rules and instructions for staff (including doctors), almost daily personally supervised the treatment process, the work of the staff and the board of trustees, and ensured that patients were supplied with money, medicine and clothing after discharge.
At the beginning of 1814, 24 widows who expressed a desire to devote themselves to caring for the sick began their duties: every two weeks, eight widows moved to the hospital for duty. They observed the condition of the wards, the order in the distribution of food and medicine, the cleanliness and tidiness of the patients, their beds and linen, the behavior of patients and visitors. At the same time, women mastered some medical techniques in order to be able to provide assistance if necessary.
In March 1815, for the first time, 16 “compassionate widows” who had completed their probationary period were sworn in and presented with an insignia - the Golden Cross, which was ordered to be worn on
neck all my life, even if the “compassionate widow” retired. From the second year of service, “widows” could visit the sick in private homes, receiving payment for this. In 1819, a special verdict followed, establishing the Institute of Compassionate Widows. The ceremony of initiation and oath was carefully thought out by the empress herself. After completing the ritual, the dedicated widows received a certificate for the title of “compassionate”, which was published in the press.
With the establishment of the Institute of Compassionate Widows, the training of female medical personnel began. In terms of medical qualifications, compassionate widows occupied a middle position between a nurse and a nanny. Since 1850, widows' duty extended to the children's hospital. The existence of the service for compassionate widows was determined by the income of widows' homes and large donations from benefactors.
In 1818, a state service of nurses was created in Russia, who were trained in hospitals in sanitary and hygienic care for the sick and had full-time positions at hospitals. But in the first half of the 19th century. This form of training for medical personnel has not received proper development and has not made a significant contribution to patient care.
Thus, until the middle of the 19th century. The service of “compassionate widows” remained the only form of professional participation of women in caring for the sick. Christopher von Oppel, the chief physician of the Mariinsky Hospital in Moscow, in which compassionate widows from the Moscow widow's home served, published a textbook in 1822, which was called: “Guidelines and rules on how to care for the sick, for the benefit of everyone involved in this matter.” , and especially for compassionate widows who have especially dedicated themselves to this title.” The manual describes the principles of selecting nursing staff, the requirements for their physical and moral qualities, and the features of caring for the seriously ill, convalescent, wounded, infants, and the dying. Much attention paid to hygienic conditions for keeping patients, methods of performing manipulations, and rules for taking medications. The book is written clearly, thoughtfully, with great love and understanding of the importance of the work begun. It has not lost its relevance even today.
This textbook was used to train female medical personnel by doctors. This method of transmitting knowledge in our country has been preserved to this day, which, in our opinion, has its own positive sides(high intelligence of doctors, good theoretical and
practical training, knowledge of the peculiarities of a nurse’s work, her professional mistakes) and negative (the attitude of doctors towards the nurse with a certain shade of superiority, a view of the nurse’s problems only in the light of her role as an assistant).
“Compassionate widows” together with the sisters of mercy participated in the Crimean campaign of 1854-1856. Despite their noble origin (many were hereditary noblewomen), women performed the most difficult, but necessary work. After the October Revolution, widows' houses were abolished, and their buildings were transferred to the People's Commissariat of Health. Since 1936, the building of the Moscow widow's house was occupied by the Central Order of Lenin Institute for Advanced Medical Studies (TSOLIUV), the administrative services of which are located there to this day (now the Russian Medical Academy of Postgraduate Education (RMAPO)).
Communities of Sisters of Charity. A qualitatively new stage in the development of nursing in Russia is associated with the organization of communities of sisters of mercy. On the initiative of Grand Duchess Alexandra Nikolaevna and Princess Theresa of Oldenburg, the first community of sisters of mercy in Russia was created in St. Petersburg (1844). The community received its name - Holy Trinity - only in 1873. The first community of sisters of mercy in Russia was based on the idea that caring for the sick and other forms of mercy could be a matter of personal achievement.
Initially, the community included seven departments: a department of sisters of mercy, a women's hospital, an almshouse for the incurable, a boarding house, a shelter for visiting children, a reformatory children's school, a department of penitents, or Magdalenes. Over time, most branches were closed. The community's activities were aimed exclusively at serving the poor and training sisters of mercy. During the opening years of the community, it consisted of 18 sisters of mercy and test subjects.
Widows and girls from 20 to 40 years old were accepted as sisters of mercy. Over the course of a year, the subjects underwent a training course and actually tested their mental and physical qualities necessary for this difficult work. The training of nurses was carried out by doctors serving in the community. Nurses were taught the rules of patient care, wound dressing techniques, pharmacy and recipes. Trained nurses performed duties that were otherwise assigned to medical assistants and paramedics. They received the sick, visited the community, and were on duty in the community hospital and private homes. Over time, they began to be invited to private and public hospitals and hospitals. Many famous doctors were invited to the community for consultations. From 1845 to 1856, the community was visited by N.I. Pirogov.
The community's activities quickly gained recognition. There was no shortage of people willing to take part in the work. However, living conditions in the communities differed sharply from those of the “compassionate widows.” Fulfillment of difficult and complex duties, ascetic life, discipline, lack of salary, pension, days off and vacations led to many sisters leaving the community. Only a quarter of the sisters stayed in the community for more than 10 years. Nevertheless, their work was more significant in terms of the volume and quality of medical care for the population than the activities of “compassionate widows.”
Since the demand for the activities of the sisters of mercy far exceeded the capacity of one community, there was a need to create new communities.
At the end of 1844 in St. Petersburg, Princess M.F. Baryatinskaya founded a community to help the needy and suffering, which a little later received a charter and the name “Community in the name of Christ the Savior.” From 1853 to 1875, 23 sisters of the community provided assistance to 103,785 patients.
In Moscow by the middle of the 19th century. There were few similar establishments. A community similar to Holy Trinity arose in Moscow in 1848 during a cholera epidemic. It was organized by two outstanding people: Princess Sofya Stepanovna Shcherbatova and Doctor Fyodor Petrovich Gaaz. This community received the name Nikolskaya. The sisters of this community took part in caring for the wounded during the Crimean campaign.
In 1850, the Sturdzovskaya almshouse for compassionate sisters was established in Odessa, which consisted of a community of sisters and a hospital in which they were trained. Only female patients received medical care in this hospital. At the hospital there was a senior doctor and several doctors and assistant doctors.
To participate in the Crimean War (1853-1856), the Holy Cross community of sisters of mercy was created.
The movement of the sisters of mercy after the Crimean campaign received a wide response in the hearts of the Russian people. One after another, new communities of sisters of mercy are opening in different cities of Russia: Moscow, St. Petersburg, Kharkov, Tiflis, etc.
Those wishing to enter the community previously underwent a probationary period of up to two years. In peacetime, the sisters looked after
patients in military hospitals and civilian hospitals, in the apartments of private individuals. In wartime, they were seconded by the community council to the disposal of the Russian Red Cross Society and distributed among hospitals.
By becoming members of the community, the sisters took on hard work and high moral responsibility. This was a special form of asceticism, which could only be endured strong-willed. They received no pensions, had no days off, no vacations. The communities were a kind of communes. They operated orphanages and schools, hospitals and outpatient clinics, craft and art workshops, and permanent nursing courses.
The charters of the communities differed little from each other. Their constant conditions were chastity and severity of behavior, love and mercy for one's neighbor, hard work and dedication, discipline and unquestioning submission to superiors. The statutes were strict, but retained some freedoms for community members (unlike monastic ones). The sisters had the right to own inheritance and their own property; if they wished, they could return to their parents who required care, or marry. Among the sisters of mercy there were many women and girls noble birth. For example, Princess Shakhovskaya began her social activities sister of mercy in the Moscow prison hospital. However, the charter did not allow anyone to make discounts, and no one sought privileges.
At the beginning of the 20th century. headed the management of charitable institutions Grand Duchess Elizaveta Fedorovna. In 1905, her husband was killed - Grand Duke Sergei Alexandrovich, Governor of Moscow. After this, the princess devoted herself entirely to charity. In 1907, Elizaveta Fedorovna established a community of sisters of mercy - the Martha and Mary Convent, named after two evangelical sisters, in whose fate two ideas were embodied: spiritual service and active charity. The community included a hospital, an outpatient clinic, a pharmacy, a shelter for orphan girls, and a Sunday school. There was also a canteen for the poor, a dormitory for the Sisters of Charity and dormitories for an orphanage. The community ensemble was conceived by the princess herself. She had a subtle artistic taste and drew well. A beautiful park with greenhouses was laid out on the territory of the community. The monastery hospital was considered exemplary at that time. The best specialists worked there
Moscow. At the outpatient clinic, medical care was provided free of charge, and medications were provided free of charge at the pharmacy. The community helped with finding a job, home care, looked after children, and provided material assistance in the form of distributing money, clothing, and food. The Sisters of Charity, together with the Grand Duchess, visited slums and prisons. Elizaveta Feodorovna treated her duties very selflessly, cared for hopeless patients, took care of the sisters of the community, walked around the wards at night, and assisted during operations. She was very strict with herself, led an ascetic life: she slept no more than 3 hours on a wooden bed without a mattress, and was very abstinent in food.
In 1914, the monastery was converted into a hospital, the wounded were admitted here, and the Empress and her daughters worked here as sisters of mercy. The activity of the monastery continued after the revolution of 1917, until the arrest of the royal family. Elizaveta Fedorovna died tragically in 1918 in Alapaevsk along with other members of the royal family. At the end of the 20th century. Elizaveta Fedorovna and her cell attendant Varvara were canonized by the Russian Orthodox Church. Currently, the Grand Duchess has many admirers not only in our country, but also abroad. The Marfo-Mariinskaya Convent works, preserving the memory of its founder. In Moscow, on Bolshaya Ordynka, a monument to a woman was unveiled, whose dedication for the good of the Fatherland, in the name of love and compassion for people, can serve as an example to follow. In August 2004, the relics of the sister of mercy, Saint Elizabeth, visited Moscow, and admirers of this most illustrious woman could venerate them.
The existence of communities of mercy was a remarkable example of asceticism, which was picked up by Russian society in the second half of the 19th century. Women have proven that they deserve to have equal rights with men in the public life of the country.
The movement of the Sisters of Charity quickly gained strength and received universal recognition. By the end of 1912, 3,442 nurses worked in 109 charitable communities, and by the beginning of the First World War their number reached almost 20,000.
During the Crimean War (1853-1856), the shortage of medical personnel was especially acute. This war claimed the lives of almost 785,000 people. At the same time, the loss in killed was 53,000, and the rest died from wounds and disease. At the height of hostilities N.I. Pirogov was invited to Grand Duchess Elena Pavlovna, who in 1828 took over the leadership of charitable institutions. She introduced him to her plan - to create a women's organization to help the sick and wounded on the battlefield and invited N.I. Pirogov to take over the organization.
In 1854, the Holy Cross community of sisters of mercy was created in St. Petersburg, specifically for work in the active army. The community charter was drawn up by N.I. himself. Pirogov. And he also led the activities of the community. The new initiative was met with skepticism in high circles. Concerns were expressed that sending a woman to the front could lead to moral decay in the army. However, women, with their selfless work and impeccable behavior, earned the respect and gratitude of not only soldiers, but also the entire people, writing a glorious page in the history of the development of nursing and domestic healthcare in general.
N.I. Pirogov highly appreciated the hard work, dedication and great moral influence that the sisters of mercy had on the soldiers. He wrote that the behavior of the sisters with doctors and their assistants was exemplary and worthy of respect, their treatment of the suffering was the most sincere, and in general all the actions of the sisters when caring for the sick, in comparison with the behavior of the hospital administration, should be called nothing less than noble.
During the Crimean War, Russian women for the first time left the sphere home life in the field civil service, showing high business and moral qualities. The sisters acquired one of the specialties: surgical nurses (dressing nurses), pharmacists and housewives. Dressing nurses helped doctors during operations and dressings, and prepared dressings. Sister-housewives supervised the care of the sick, the cleanliness of linen and beds. Nurse pharmacists had to monitor the correct distribution of medicines and checked the work of paramedics.
“Compassionate widows” worked together with the sisters of the Holy Cross and St. Nicholas communities in Crimea. The best evidence of the women's selfless work is the fact that 12 widows died. Of the 60 sisters of mercy, almost all fell ill with typhus, 11 of them died.
The events of those years were preserved in the reports of the great surgeon, his memoirs and diary entries. They are most fully reflected in the “Sevastopol Letters”, which were documents of political content and had an impact on significant influence on public opinion in Russia. Memories left us with the names of these great women, including noblewomen E. Bakunina, E. Khitrovo, A. Travina, M. Grigorieva and others.
Ekaterina Mikhailovna Bakunina (1812-1894) was distinguished by her unusually high moral and strong-willed qualities and precise performance of her duties as a nurse. N.I. Pirogov called her a tireless sister and considered her his faithful assistant. “Every day, day and night,” he recalls, “one could find her in the operating room, present at the operation, at a time when bombs and missiles either flew over or did not reach and lay around, ... she discovered with her accomplices a presence of mind barely compatible with female nature.”
Ekaterina Mikhailovna was brought up in the spirit of the best family and national traditions, on the wonderful images of Russian classical literature. Her pedigree is the interweaving of two famous families in Russia: the Bakunins and the Golenishchev-Kutuzovs. Ekaterina Mikhailovna’s grandfather Ivan Loginovich had a friendship with Mikhail Illarionovich Kutuzov for many years, and they were married to sisters, so Ekaterina Mikhailovna can be considered great-niece great commander.
In her declining years, Ekaterina Bakunina wrote “Memoirs of a Sister of Mercy,” the only one of its kind in the entire vast literature about the Crimean War, not counting “The Historical Mode of Action of the Holy Cross Community...” by N.I. himself. Pirogov.
In the first post-war years E.M. Bakunina, on the recommendation of Pirogov, led the Holy Cross community. But in the summer of 1860, she voluntarily resigned as sister abbess and parted with the community forever. The reason for such a serious step was disagreements with Elena Pavlovna on issues of further development and activities of the community. Further life of E.M. Bakunina confirmed the spiritual wealth of her nature: until the end of her days, she tirelessly struggled with human misfortune - she treated peasants in the village of Kozitsino, Novotorsky district, Tver province, where she lived with her sisters. Participation in the Russian-Turkish War is one of the brightest pages of her interesting, but not yet written biography.
In the memoirs of N.I. Pirogov, doctors, and contemporaries, information about Daria Lavrentievna Mikhailova (real name Dasha Sevastopolskaya) has been preserved. She was one of those wives, sisters, and daughters of Sevastopol residents who, even before the appearance of sisters of mercy and “compassionate widows,” provided assistance to the wounded. One of his contemporaries wrote that Dasha, who was left an orphan, first earned money by washing clothes and, together with the laundresses, followed the troops with her cart. Fortunately, in her cart there was both vinegar and some rags, which she used to bandage her wounds. Thus, Daria Mikhailova became the first sister of mercy on the battlefield.
Nicholas I learned about the girl’s feat from letters from his sons, who were in Crimea to “raise the spirit” of the Russian army, and took direct part in the girl’s fate. Daria was awarded a gold medal on the Vladimir ribbon with the inscription “For zeal” and 500 rubles in silver. She lived a long, modest life without reminding of herself. Unfortunately, neither the date of her death nor the place of burial have been established.
On the occasion of the 150th anniversary of the birth of Dasha of Sevastopol, on the initiative of the command of the medical service of the Red Banner Black Sea Fleet, the Red Banner Naval Hospital named after N.I. Pirogov and the Council of the Museum of the Fleet Medical Service approved a medal named after her. It was manufactured at the Sergo Ordzhonikidze Marine Plant production association. Every year the hospital hosts a competition for the title of best nurse. Those who occupy the highest step of the podium are awarded a medal named after Dasha of Sevastopol and are included on the Honor Board.
The efforts of N.I. Pirogov and the sisters themselves were not in vain. In his memoirs, he wrote that the results of the sisters’ participation in the war and the first experience of creating communities proves that until now the wonderful talents of our women have been completely ignored. He was worried about the future of the community, its internal life. “Our sister,” wrote Pirogov, “must be a woman with a practical mind and a good technical education, and at the same time she must certainly maintain the sensitivity of her heart, and such activity in women must be constantly supported. The nurses themselves should be independent of the administration, and the most educated ones should morally influence the entire hospital staff.” He believed that the activities of the sisters of mercy, despite all the difficulties, had a great future. He sums up the activities of the Holy Cross community this way: “...I hope that this young institution will be introduced in our other military hospitals forever. Every right-thinking doctor who wants his orders not to be carried out by the rough hand of a paramedic must sincerely wish for the prosperity of compassionate care for the sick.”
At the end of the war, 68 sisters were nominated for the medal “For the Defense of Sevastopol”. Of the 120 sisters of mercy of the Holy Cross community sent to Crimea, 17 died in the line of duty. Their memory is sacred to us.
Participation in the Russian-Turkish War (1877-1878). The heroine of the Russian-Turkish war was the sister of mercy Yulia Vrevskaya. Baroness, the daughter of a general, she considered “self-sacrifice for the good of others” her duty. V.A. Sologub wrote: “I have never met such a captivating woman in my entire life. Captivating not only for her appearance, but also for her femininity, grace, endless friendliness and endless kindness. This woman never said anything bad about anyone and did not allow anyone to slander anyone, but, on the contrary, she always tried to bring out the good sides in everyone.” From the very beginning of the war, Yulia goes to the front: “For 400 people, there are 5 of us sisters, all of our wounds are very serious. I'm in the hospital all day." Yulia Vrevskaya refused her allotted leave and died of typhus in a military hospital in the Bulgarian city of Byala on January 24, 1878. In memory of Yu.P. Vrevskoy dedicated his prose poem to I.S. Turgenev.
Russian Red Cross Society. The founding meeting of the Society for the Care of Wounded and Sick Soldiers took place in St. Petersburg on May 18, 1867. Renamed the Russian Red Cross Society (ROSC) in 1879, it became a wealthy and influential organization carrying out missions to help the wounded in war and those affected by natural disasters. disasters both within the country and abroad.
In 1879, the competence of the ROKK included: organizing the training of sisters of mercy and monitoring the establishment and activities of communities of mercy. Most communities joined the ROKK, including the famous Holy Cross in St. Petersburg. By January 1, 1894, the ROCC had 49 mercy communities at its disposal. In 1903, the network of ROKK institutions with headquarters in St. Petersburg consisted of departments, committees, communities of sisters, hospitals, outpatient clinics, nursing homes, and orphanages.
In 1897 Russian society The Red Cross established the Brothers of Charity Institute in St. Petersburg, the purpose of which was to train male personnel to care for the sick and wounded and provide assistance in accidents. The training lasted 2 years. Except
communities of the Red Cross, training of sisters was also carried out at hospitals and monasteries.
The number of women who aspired to become sisters was constantly growing. Nursing training courses were organized in many large cities for all those wishing to join the profession. For future nurses, lectures were given and practical classes were conducted under the guidance of surgeons and special curators, in accordance with the standards and programs developed by the leaders of the RCCS.
The sisters' work was very highly paid, and their status was equal to that of a captain or major. Russian army. In addition to the monthly allowance, which was higher than that of officers, women received additional funds for travel and sewing several sets of uniforms. In addition, the ROKK guaranteed pensions after 25 years of service and payment of benefits in case of illness acquired during the performance of official duties.
Development of nursing in 1918-1977.
The main events of this period of nursing development are presented in the table;
Analyzing the main milestones in the development of nursing in the post-October period, it should be said that the reforms began with the approval in 1919 by the People's Commissar of Health of the training plan and programs for schools of sisters of mercy, which provided for a purely practical method of teaching and, therefore, the constant stay of students in the hospital.
The young country needed new sisters who could be trained by schools that were fundamentally different from the schools of mercy. Thus, in 1920, the word “mercy” disappeared from medical usage. Communities of sisters of mercy are liquidated, the first state medical schools appear. In the new programs of the 1924 edition, it was noted that “the nurse must not only be a mechanical executor of the doctor’s prescription, but must be clearly aware of the significance of the specified method of treatment”; in the 1926 programs - that “the average health worker should only be an assistant to the doctor, working according to his instructions and under his supervision.” And only in 1929 was the issue of improving the qualifications of nursing staff resolved (at least once every 5 years).
Table. Main milestones in the development of nursing in Russia in 1919-1977.
After the nurse's specialty was reinstated (circa 1932), new training requirements specified that she perform nursing care under the direction of a physician or physician's assistant, and that she must be medically literate in order to be conscientious about the physician's orders.
In 1934, mass training of adults began under the GSO program (Ready for the sanitary defense of the USSR), as well as training for schoolchildren under the BGSO program (Be ready for the sanitary defense of the USSR). These programs included issues of first aid for wounds, injuries, issues of hygiene, sanitary care, and infectious diseases. At the same time, sanitary squads and posts were formed.
In 1936, a unified system for training paramedical personnel was introduced. Since 1939, the training of nurses began in each republic. Already in 1940, there were 967 medical and sanitary schools and departments in the former USSR.
During the Great Patriotic War, for the first time in the world, Soviet army A woman, a medical instructor, was brought to the line of fire, whose duties included carrying out the wounded and providing them with emergency assistance. On August 23, 1941, an order was issued “On the procedure for providing medical instructors and porters with government awards.” For removing 15 wounded from the battlefield with their rifles and light machine guns, the medical instructor was presented with a government award - the medal “For Military Merit” or “For Courage”; for the removal of 25 wounded - the Order of the Red Star; for the removal of 40 wounded with their rifles and light machine guns - to the Order of the Red Banner; for the removal of 80 wounded with their rifles and light machine guns - to the Order of Lenin. In the German army, only men were used as orderlies and medical instructors. For 7 wounded carried out (without personal weapons) the Iron Cross was awarded.
Yulia Drunina, a famous poet and public figure, a former battalion medical instructor, holder of the military orders of the Patriotic War, 1st degree, and the Red Star, writes: “I don’t come from childhood, from war... How many times has it happened to me - I need to take a wounded man out from under fire , but not enough strength. I want to unclench the fighter’s fingers to free the rifle - after all, it will be easier to drag. But the fighter grabbed her with a death grip. Almost without memory, but my hands remember the first soldier’s commandment - never, under any circumstances, throw away your weapon.”
The mortality rate among company instructors was the highest, sometimes only 30% of the personnel emerged from battles. “Not a single wounded person should remain on the battlefield” - this requirement in the difficult year of 1941 was not only a call. The everyday life of war knows many cases when the rescue of one wounded man cost the lives of two or three orderlies, although their actions were often covered by the fire of an entire unit. Our country takes credit for organizing women's sanitary care on the battlefield. But is this something to be proud of?
24 medical instructors were awarded the title of Hero of the Soviet Union, including 10 people posthumously. The poet M. Svetlov wrote about them, about the dead:
On a long stretcher, under a canopy
Russian princesses were dying. The machine gunners stood quietly nearby in State Sadness. The Yegoryevsk Medical School in the Moscow region is named after Zinaida Samsonova. She was a fighting friend of Yulia Drunina. The poem “Zinka” is dedicated to her.
We did not expect posthumous glory, We wanted to live with glory. Why is the Blonde soldier lying in bloody bandages? According to generalized data, first aid was provided within the first hour after injury to 66.5% of all wounded, and 88.6% received it in the first 2 hours. This was important to achieve good treatment results. After recovery, 72.3% of the wounded and 90.6% of the sick were returned to duty.
War is over. “You took off your soldier’s overcoat, put on your old shoes” and began your pre-war duties. In 1961, 2 participants of the Great Patriotic War - guard lieutenant colonel of tank forces, writer, Hero of the Soviet Union, Muscovite Irina Nikolaevna Levchenko and surgical nurse, chairman of the primary organization of the Red Cross of the Leningrad Skorokhod factory Lidia Filippovna Savchenko - were awarded the Florence medal for the first time in Russia Nightingale.
Starting from 1954, in accordance with the resolution of the Council of Ministers of the USSR of May 14, training periods were unified depending on general training(based on 9- and 11-year education), a network of medical schools was streamlined, specialization was introduced for nurses in clinical nutrition, massage, physiotherapy, physical therapy, anesthesiology, etc.
An analysis of changes in nursing during this period shows that the main focus was on educational reform. This is evidenced by fairly frequent revisions of curricula, which differed from each other only in the number of academic disciplines of the “university” set.
From our point of view, this did not in any way affect the activities of practical nurses. Defined back in 1927, their professional and social status basically remains in Russian healthcare to this day. A conscious attitude towards the doctor’s prescriptions, even if it is developed, remains unclaimed among the majority of nurses: the doctor bears responsibility.
Conclusions for nursing development
Interconnectedly it includes questions of the place and role of a woman in society, her professional abilities and professional self-realization, as well as the formation of various professions.
- The first women's religious organization that was involved in charity was founded in France in 1633.
- One of the factors that hindered the development of nursing in the world was the social status of women. Florence Nightingale made a huge contribution to women's equality. She was the first to draw attention to the significance and features of nursing, which determine its specificity and its separation into an independent type of professional activity. On her initiative, the world's first secular school for training nurses was opened in London in 1860.
- In 1899, the International Council of Nurses was created - the first professional organization of women.
- The first organizer and legislator of nursing in Russia was Peter I, on the basis of whose decrees women’s care work began to be used, and then increasingly specified and specified. At the same time, in the 18th century. Women's participation in care was not systematic. According to the staff, the hospitals had both soldier-sitters and women-sitters.
- In the first half of the 19th century. the service of “compassionate widows” remained the only form of women’s participation in caring for the sick
in Russia. With the establishment of the Institute of Compassionate Widows (1819), the training of female medical personnel began.
- "Management." H. Oppel (1822) was the first work known to us that made an attempt to emphasize the importance of the activities of nursing staff, highlight the specifics of the work of nurses in various specialties, and also outline the structure of activities and professional knowledge.
- The first community of Russian sisters of mercy - Holy Trinity - was created in 1844 in St. Petersburg.
- In 1854, the Exaltation of the Cross community of sisters of mercy was created in St. Petersburg, specifically intended for work in the army. The community charter was drawn up by N.I. Pirogov. During the war, the sisters acquired one of the specialties: surgical nurses (dressing nurses), pharmacists and housewives. History has preserved the names of those great women: D. Sevastopolskaya, E. Bakunina, E. Khitrovo, A. Travina, M. Grigorieva and others.
- In 1867, the Russian Red Cross Society was established. His competence included organizing the training of sisters of mercy and monitoring the establishment and activities of communities of mercy.
- At the beginning of the 20th century, the leadership of charitable institutions was headed by Grand Duchess Elizaveta Feodorovna, who at the end of the century was canonized by the Russian Orthodox Church.
- The movement of communities of mercy is a wonderful example of asceticism. Communities of Sisters of Charity played a major role in the development of women's intellectual and emotional potential in Russia.
- In 1920, the first state medical schools appeared in Russia. In 1929, the issue of improving nursing staff was resolved, the frequency of which (at least once every 5 years) continues to this day. In 1936, a unified system for training paramedical personnel was introduced.
- During the Great Patriotic War, for the first time in the world, a female medical instructor was placed in the line of fire in the Soviet army. 24 medical instructors were awarded the title of Hero of the Soviet Union, including 10 people posthumously.
- An analysis of changes in nursing shows that from 1945 to 1986 the focus was on educational reform. From our point of view, this did not in any way affect the activities of practical nurses. Their professional and social status, determined back in 1927, is basically preserved in Russian healthcare to this day.
- Certain damage to the prestige of the nursing profession has been and is being caused by the fact that a nurse performs the function of a doctor’s assistant, and abroad the concept of partnership between these specialists is increasingly being established.
- The attitude towards a nurse only as a doctor’s assistant and the concept of “paramedical worker” hinders the development of professional self-awareness of nurses. The lack of scientific principles in the system of training nurses and prospects for professional growth gave rise to many problems in Russian healthcare.
Fundamentals of nursing: textbook. - M. : GEOTAR-Media, 2008. Ostrovskaya I.V., Shirokova N.V.
Medical Worker Day in Russia began to be celebrated on the basis of the Decree of the Presidium of the Supreme Soviet of the USSR dated October 1, 1980 “On holidays and memorial days.”
“The profession of a doctor and a nurse is special: at all times, those who have chosen to care for people’s health have been respected and deservedly appreciated. The work of a physician requires special qualities, including fidelity to duty, empathy, and the inability to remain aloof from the pain of others,” noted Minister of Health Veronika Skvortsova, congratulating representatives of this profession.
On this day, AiF.ru remembered five stories of people who dedicated their lives to saving others.
It is difficult to calculate how many lives the Austro-American explorer Karl Landsteiner saved. Already now the count is in the billions. And this number will continue to grow, because the scientist discovered blood groups. Even before this, doctors tried to transfuse blood from one person to another, but the successful outcome of this procedure at that time was pure luck.
Karl Landsteiner was born on June 14, 1868 in Vienna. His father died quite early, and Faina’s mother raised her son alone. In 1891, the young man graduated from the medical school of the University of Vienna, but Landsteiner was much more interested in chemistry, especially organic. In the future, the scientist will focus on only one area of this broad field—immunolongation. And he will make a discovery that will change the course of science.
Knowing this, Jenner decided that infecting a person with cowpox was much safer than resorting to variolation. Contemporaries at first ridiculed his initiative. Cartoons repeatedly appeared in newspapers of the time depicting people with parts of a cow's body. However, public condemnation did not stop Jenner. And soon the success of his method led to the fact that smallpox vaccination became common practice. It is worth noting that, despite his merits, the doctor from England never tried to make money from vaccination, considering helping people his duty.
John Franklin Enders
In the scientific community, scientist John Franklin Enders is sometimes called the "father of modern vaccines." He received this nickname for his work in the field of virology. In 1954, the American received the Nobel Prize in Physiology or Medicine for his research. The measles vaccine he created in collaboration with Thomas Weller And Frederick Robbinson, saved the lives of 120 million people. In 1954, in the laboratory of a pediatric hospital in Boston, he and his collaborators were able to create a strain that caused immunity, but not the disease itself. It was its development that served as the basis for the creation of modern measles vaccines.
But it’s not only in laboratories that you can find medical heroes. During the war, doctors and nurses risk their lives to carry the wounded from the battlefield and provide them with emergency care. Zinaida Tusnolobova-Marchenko was one of these nurses. When her husband was called to the front in 1941, she completed medical courses and volunteered for the war. Zinaida received her first baptism of fire on July 11, 1942. The battle lasted three days, and she suffered 40 wounded. For her feat, Tusnolobova-Marchenko was awarded the Order of the Red Star. However, already in 1943, the brave nurse took part in a battle that left her without arms and legs.
Zinaida Tusnolobova-Marchenko. Photo: Commons.wikimedia.org The regiment fought in the Kursk region. The woman was told that the commander had been wounded. Tusnolobova-Marchenko ran towards him, but was wounded in the leg. I had to crawl. When the nurse got to the commander, he had already died. However, he still had a folder with secret papers in his hands. The woman grabbed her and tried to crawl to her allies, but another explosion stunned the nurse. When Tusnolobova woke up, the Germans were already walking across the field and finishing off those who remained alive. She could no longer defend herself, so she pretended to be dead. Approaching her, the fascist began to beat her with a rifle butt, causing her to lose consciousness again. But she didn’t die. The nurse was rescued by orderlies-porters who took away the dead. At the hospital where she was taken, the doctor saw that the woman had developed gangrene. I had to amputate my right leg up to the knee, my left foot, part right hand and left hand.
The woman bravely endured all the operations, which were often performed with little or no anesthesia. But she was afraid to return to her husband in this form. Therefore, she wrote him a letter in which she asked him to forget about her. The husband, however, did not abandon his beloved. When he returned from the front, the family had two children.
Maria Borovichenko. Photo: Commons.wikimedia.org
During the Great Patriotic War, more than 85 thousand doctors died or went missing. Average duration the life of a medical instructor on the front line in 1941 was 40 seconds. Among those who did not return from the front was Maria Borovichenko. The girl went to war when she was not yet 17 years old. However, for her exploits she was posthumously awarded the title of Hero of the Soviet Union.
The fragile teenager surprised his commanders more than once. When she first got to the front, the girl approached the general Rodimtsev and told about all the enemy army batteries, machine gun points and German weapons warehouses that she saw while she was getting there. Borovichenko was appointed as a nurse to the first rifle battalion of the 5th airborne brigade. And just two days later, during the battle, she carried eight soldiers on herself, managing to shoot two fascists. In 1941, in a battle near the Ukrainian city of Konotop, a girl carried out 20 wounded.
Brave nurse died in 1943 while protecting Lieutenant Kornienko. A shell fragment hit her right in the heart. Veterans of the unit where she served asked to perpetuate the memory of Maria Borovichenko. In 1965, the Presidium of the Supreme Soviet of the USSR fulfilled this request. In the same year, director Shulamith Tsybulnik shot the film “No Unknown Soldiers”, the prototype of which was a brave teenage girl.
*Blood serum- blood plasma devoid of fibrinogen protein. Most of the antibodies are retained in the sera, and due to the absence of fibrinogen, stability sharply increases.
**Red blood cells- red blood cells that carry oxygen and nutrients to tissues and organs.
There is very little historical information about women's medical activities in Rus'. It is known that Orthodox monasteries played a huge role in caring for the sick, where almshouses for lepers were created (1551). The first hospital in which doctors treated and monks served was built in 1618 at the Trinity Monastery (Sergiev Posad). In connection with the reforms of Peter I, the “Medical College” was created, which in 1728 introduced staff positions for women to care for the sick to work in hospitals. By the mid-18th century, women's nursing began to take place in civilian hospitals. In 1804, the trustee of the Moscow Orphanage was asked to build a new house for widows next to the hospital for the poor, so that some of them would take care of the sick for a reasonable fee. In 1813, at the St. Petersburg widow's home, it was decided to employ a certain number of widows to work in the Mariinsky Hospital for the poor, as well as to care for the sick at home. The widows on duty had to monitor the improvement of the wards, the order in the distribution of food and medicine to the sick, the cleanliness and tidiness of the patients, their beds and linen, and the behavior of the patients and visitors. Doctors and healers had to give widows the necessary instructions on caring for the sick. “Compassionate widows” had to master some medical techniques in order to provide assistance to the sick themselves, if necessary. With a large influx of wounded and sick, medical institutions could not cope without auxiliary female labor, and therefore in 1818 a state service of nurses was created, who were trained in hospitals in sanitary and hygienic care for the sick and had full-time positions at hospitals. Until the mid-19th century, the service of “Compassionate Widows” remained the only form of professional participation of women in caring for the sick in Russia.
In the mid-19th century, communities of sisters and brothers of mercy were created in Europe. Later, women's communities took over the care of the sick. The first community in Russia sisters of mercy was opened in March 1844, and only in 1873 received its name “Holy Trinity”. According to the charter, girls and widows aged 20 to 40 were accepted into the community. The first year of work was a probationary year, where the mental and physical qualities necessary for work were tested, which only strong-willed women could withstand. The doctors taught the sisters the rules of caring for the sick, how to dress wounds, pharmacy, and recipes. A year later, the sisters took the oath and became full members of the community. Over time, they began to be invited to private and public hospitals.
From 1845 to 1856, the community was visited by N.I. Pirogov, who performed the most complex operations and autopsies of the bodies of the dead there. While working in the community, he expressed the following thought: “It has already been proven by experience that no one better than women can sympathize with the suffering of the patient and surround him with constant care and, so to speak, unusual for men.”
Demand for activities was growing in Russia sisters of mercy and this contributed to the creation of new communities in other cities. The shortage was especially acute sisters of mercy during the Crimean War 1853-1856.
Pirogov proposed dividing the nurses into dressing nurses, attendants, pharmacists and housewife sisters, developing special instructions for each of these groups, which significantly increased the quality of the nurses’ work and their responsibility.
In order to encourage and perpetuate the merits of the sisters in the Crimean War, the Committee of the Holy Cross Community established a gilded cross, which was awarded to 158 sisters. It was during the Crimean War that a Russian woman first emerged from the sphere of domestic life into the field of public service, showing high business and moral qualities.
The experience of the Crimean campaign was developed in the Russian-Turkish war of 1877-1878.
By 1877, there were about 300 certified nurses in Russia. During the Russian-Turkish War 6 nurses were awarded silver medals “For Bravery”, and almost all the sisters received the insignia of the Red Cross. All participants in the war received medals established in memory of the Russian-Turkish war of 1877-1878.
After the October Revolution of 1917, almost all training centers sisters of mercy were subordinate to the Main Directorate of the Russian Red Cross Society. On August 7, 1918, the Council of People's Commissars of the RSFSR issued a decree that granted the Soviet Red Cross the legal rights of a public organization.
In 1920, schools were opened to train nurses. In October 1922, at the 1st All-Russian Conference on Secondary Medical Education, the types of secondary medical educational institutions and the main profiles of training nurses were determined: nursing for medical institutions, for the protection of motherhood and infancy, for social assistance. In 1926, the 2nd All-Russian Conference on Secondary Medical Education was held in Moscow, which prepared a reform to unify the training of nursing personnel. All medical colleges, schools, courses were reorganized into medical technical schools, in which all applicants were given a unified general medical training with further specialization. The duration of training for nurses there was 2.5 years. At the 3rd and 4th All-Russian conferences on secondary medical education, the principle of polytechnic education of nurses was consolidated and deepened. To replace the definition "sister of Mercy" another came - “nurse”. In 1927, the Regulations on nurse, which clearly defined the responsibilities of the nurse in caring for the sick. From that time on, the professional status of the nurse was defined.
During the Great Patriotic War of 1941-1945. 500,000 paramedical workers fulfilled their patriotic duty. Thanks to medical care, 70% of wounded and sick soldiers were returned to duty, and nurses played a significant role in this success.
A monument has been erected in several cities around the world nurse.
In 1965, advanced training courses for nurses were created. In the same year, by order of the USSR Ministry of Health No. 395, the position of chief nurse was approved. In 1977, Appendix No. 45 to the same order in staffing table medical institutions, the position of senior nurse is being introduced.
The main purpose of nursing is to provide care to the patient. The work of nursing the sick and suffering, having gone through different stages of development of asceticism, became a profession. Currently, nursing education has entered a new stage of development. New levels of nursing education have been introduced. Since 1991, medical colleges and the first faculties of higher nursing education in medical universities have emerged. Their appearance is associated with the introduction of three levels of nursing education, each of which has professional completion.
The Association was created in 1994 nurses Russia, taking an active part in the work of the International Council of Sisters.
The highest level in nursing education is Academic Nursing Education, which can be obtained at the faculties of higher nursing education of medical academies and universities.
Along with higher education, a nurse receives the qualification of a manager. For the Faculty of Higher Nursing Education, special educational plans, including, along with well-known ones, completely new disciplines in the field of nursing: nursing theory, management and leadership in nursing, marketing of nursing services, management psychology, legislation and health economics, pedagogy and others. Healthcare is accepting new nursing specialists into its ranks, specialists with a higher level of knowledge capable of solving the problems facing medical institutions.
International Nurses Day is celebrated on May 12, the birthday of the Englishwoman. Florence Nightingale , which made an invaluable contribution to the development of nursing.
First definition "nursing" given by the legendary Florence Nightingale in “Notes on Care,” published in 1859. In 1865, this term was adopted by the International Committee of the Red Cross. In the second half of the 19th century Florence Nightingale created the first medical schools, which served as a model for the development of nursing education in other countries of the world.Florence Nightingale monuments were erected in England and France, a ship was named after her in her homeland, and Queen Victoria gave her a diamond brooch with the inscription: “Blessed are the merciful.” Florence Nightingale (1820-1910) is the author of many books and articles about the meaning, role, activities, and training of nurses. The sisters of mercy, finishing school, pronounced a composedFlorence Nightingale a solemn oath in which were the following words: “With all my might I will strive to help the doctor in his work and devote myself to ensuring the health of those who turn to me for help.” The selfless woman became an example of service to people and a prototype of international charity.Florence Nightingale is considered the founder of the Institute of Sisters of Mercy in Western Europe.
Medal with a picture Florence Nightingale are awarded for the special merits of distinguished nurses. On the reverse side of the medal, the Latin inscription in a circle reads: “Pro Vera Misericordia et cara Humanitate Perennis ducor universalis” (“For true mercy and care for people, arousing the admiration of all mankind”) and in the middle is the engraved surname of the owner. The Florence Nightingale Medal was established in 1912. To date, about 1,000 people have been awarded this medal, including 46 Russian nurses.